Active NPI
Patrick Kunkel, D.D.S., M.S.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- Sandy, UT
National Provider Identifier
1194201467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- -12012388A
- Practice address
- 641 W 9000 S
Sandy, UT 84070-2580 - Phone
- (385) 900-5200
- NPI assigned
- Jul 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 10796726-9921 | UT | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | -12012388A | IN | Primary |
Addresses
Primary practice location
641 W 9000 S
Sandy, UT 84070-2580
Mailing address
826 Spring Mill LN
Indianapolis, IN 46260-3535
Other practice location 1
12569 2700 W
#100
Riverton, UT 84065
Phone (801) 999-4431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| -12012388A | IN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 10796726-9921 | UT | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1194201467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 SPRING MILL LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462603535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "641 W 9000 S",
"city": "SANDY",
"state": "UT",
"postal_code": "840702580",
"telephone_number": "385-900-5200"
}
],
"practiceLocations": [
{
"address_1": "12569 2700 W",
"address_2": "#100",
"address_purpose": "LOCATION",
"city": "Riverton",
"state": "UT",
"postal_code": "84065",
"country_code": "US",
"telephone_number": "801-999-4431",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUNKEL",
"first_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-19",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "UT",
"license": "10796726-9921",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IN",
"license": "-12012388A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.